COVID-19 Mortality and Progress Toward Vaccinating Older Adults — World Health Organization, Worldwide, 2020–2022
Authors: Man Kai Wong, Donald J. Brooks, Juniorcaius Ikejezie, Marta Gacic-Dobo, Laure Dumolard, Yoann Nedelec, Claudia Steulet, Zyleen Kassamali, Ayse Acma, Brian N. Ajong, Sandra Adele, Maya Allan, Homa Attar Cohen, Adedoyin Awofisayo-Okuyelu, Finlay Campbell, Veronica Cristea, Stephane De Barros, Ntokwo Vabi Edward, Aura R. Escobar Corado Waeber, Tondri N. Guinko, Henry Laurenson-Schafer, Mostafa Mahran, Raquel Medialdea Carrera, Samuel Mesfin, Emily Meyer, Alessandro Miglietta, Bernadette B. Mirembe, Maribeth Mitri, Ingrid Hammermeister Nezu, Stephanie Ngai, Ojong Ojong Ejoh, Sydel R. Parikh, Emilie Peron, Nikola Sklenovská, Savine Stoitsova, Kazuki Shimizu, Eri Togami, Yeo Won Jin, Boris I. Pavlin, Ryan T. Novak, Olivier Le Polain, James A. Fuller, Abdi Rahman Mahamud, Ann Lindstrand, Bradley S. Hersh, Katherine O’Brien, Maria D. Van Kerkhove
Journal: MMWR Morbidity and Mortality Weekly Report (2023)

After the emergence of SARS-CoV-2 in late 2019, transmission expanded globally, and on January 30, 2020, COVID-19 was declared a public health emergency of international concern.* Analysis of the early Wuhan, China outbreak (1), subsequently confirmed by multiple other studies (2,3), found that 80% of deaths occurred among persons aged ≥60 years. In anticipation of the time needed for the global vaccine supply to meet all needs, the World Health Organization (WHO) published the Strategic Advisory Group of Experts on Immunization (SAGE) Values Framework and a roadmap for prioritizing use of COVID-19 vaccines in late 2020 (4,5), followed by a strategy brief to outline urgent actions in October 2021.† WHO described the general principles, objectives, and priorities needed to support country planning of vaccine rollout to minimize severe disease and death. A July 2022 update to the strategy brief§ prioritized vaccination of populations at increased risk, including older adults,¶ with the goal of 100% coverage with a complete COVID-19 vaccination series** for at-risk populations. Using available public data on COVID-19 mortality (reported deaths and model estimates) for 2020 and 2021 and the most recent reported COVID-19 vaccination coverage data from WHO, investigators performed descriptive analyses to examine age-specific mortality and global vaccination rollout among older adults (as defined by each country), stratified by country World Bank income status. Data quality and COVID-19 death reporting frequency varied by data source; however, persons aged ≥60 years accounted for >80% of the overall COVID-19 mortality across all income groups, with upper- and lower-middle-income countries accounting for 80% of the overall estimated excess mortality. Effective COVID-19 vaccines were authorized for use in December 2020, with global supply scaled up sufficiently to meet country needs by late 2021 (6). COVID-19 vaccines are safe and highly effective in reducing severe COVID-19, hospitalizations, and mortality (7,8); nevertheless, country-reported median completed primary series coverage among adults aged ≥60 years only reached 76% by the end of 2022, substantially below the WHO goal, especially in middle- and low-income countries. Increased efforts are needed to increase primary series and booster dose coverage among all older adults as recommended by WHO and national health authorities.